RATIONALE & OBJECTIVE Despite substantial growth in the population of older adults with kidney disease, there remains a lack of evidence to guide clinical care for this group. The Kidney Disease and Aging Research Collaborative (KDARC) conducted a Delphi study to build consensus on research priorities for clinical geriatric nephrology. STUDY DESIGN Asynchronous modified Delphi study. SETTING & PARTICIPANTS Clinicians and researchers in the US and Canada with clinical experience and/or research expertise in geriatric nephrology. OUTCOME Research priorities in geriatric nephrology. ANALYTICAL APPROACH In the first Delphi round, participants submitted free-text descriptions of research priorities considered important for improving the clinical care of older adults with kidney disease. Delphi moderators used inductive content analysis to group concepts into categories. In the second and third rounds, participants iteratively reviewed topics, selected their top 5 priorities, and offered comments used to revise categories. RESULTS Among 121 who were invited, 57 participants (47%) completed the first Delphi round and 48 (84% of enrolled participants) completed all rounds. After 3 rounds, the 5 priorities with the highest proportion of agreement were: 1) Communication and Decision-Making about Treatment Options for Older Adults with Kidney Failure (69% agreement), 2) Quality of Life, Symptom Management, and Palliative Care (67%), 3) Frailty and Physical Function (54%), 4) Tailoring Therapies for Kidney Disease to Specific Needs of Older Adults (42%), and 5) Caregiver and Social Support (35%). Health equity and person-centricity were identified as cross-cutting features that informed all topics. LIMITATIONS Relatively low response rate and limited participation by private practitioners and older clinicians and researchers. CONCLUSIONS Experts in geriatric nephrology identified clinical research priorities with the greatest potential to improve care for older adults with kidney disease. These findings provide a roadmap for the geriatric nephrology community to harmonize and maximize the impact of research efforts.

中文翻译：

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确定老年肾病学的研究重点：临床医生和研究人员的 Delphi 研究。


尽管患有肾病的老年人口大幅增长，但仍缺乏证据来指导这个群体的临床护理。肾脏病与衰老研究合作组织 （KDARC） 进行了一项 Delphi 研究，以就临床老年肾病学的研究重点达成共识。研究设计 异步修改的 Delphi 研究。地点和参与者 在美国和加拿大的临床医生和研究人员，具有老年肾病学的临床经验和/或研究专长。结果 老年肾病学的研究重点。分析方法 在第一轮 Delphi 中，参与者提交了被认为对改善患有肾病的老年人的临床护理很重要的研究重点的自由文本描述。Delphi 版主使用归纳内容分析将概念分组。在第二轮和第三轮中，参与者迭代审查主题，选择他们的前 5 个优先事项，并提供用于修改类别的评论。结果在受邀的 121 名参与者中，57 名参与者 （47%） 完成了第一轮德尔菲测试，48 名参与者 （84% 的注册参与者） 完成了所有轮次。经过 3 轮调查，同意比例最高的 5 个优先事项是：1） 关于肾功能衰竭老年人治疗方案的沟通和决策（69% 同意），2） 生活质量、症状管理和姑息治疗 （67%），3） 虚弱和身体机能 （54%），4） 根据老年人的特定需求定制肾病疗法 （42%）， 5） 照顾者和社会支持 （35%）。健康公平和以人为中心被确定为贯穿所有主题的交叉特征。 局限性 反应率相对较低，私人医生和老年临床医生和研究人员的参与有限。结论 老年肾病学专家确定了最有可能改善老年肾病患者护理的临床研究重点。这些发现为老年肾病学界提供了协调和最大化研究工作影响的路线图。